Knee Surgery and Related Research最新文献

{"title":"Assessment and quantification of ipsilateral and contralateral ankle joint alignment changes after unilateral total knee arthroplasty for knee osteoarthritis with varus deformity: a retrospective cohort study.","authors":"Ahmed A Khalifa, Amr A Fadle, Abdelrahman A Aziz Khalaf, Ahmed M Abdelaal, Mohamed M A Moustafa","doi":"10.1186/s43019-025-00277-2","DOIUrl":"10.1186/s43019-025-00277-2","url":null,"abstract":"<p><strong>Purpose: </strong>The study's primary objective was to assess and quantify the ipsilateral (side A) and contralateral (side B) ankle joint line orientation (AJLO) changes after unilateral total knee arthroplasty (TKA) for primary knee osteoarthritis (OA) with varus deformity. The secondary objectives were to detect if there was a correlation between the knee deformity correction and AJLO changes and if the knee and ankle clinical outcomes on the TKA side correlate with joint alignment changes.</p><p><strong>Methods: </strong>This retrospective cohort study included 70 patients with a mean age of 61.76 ± 5.96 years. The lower limb alignment was evaluated using the hip-knee-ankle (HKA) angle, while the AJLO was assessed using the tibial plafond to horizontal line angle (TPHA). The functional outcomes for side A were evaluated at a median follow-up of 18 (interquartile range (IQR): 12-46.2) months using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and The American Orthopaedic Foot and Ankle Society (AOFAS) score for the knee and ankle joints, respectively.</p><p><strong>Results: </strong>In side A, the HKA significantly improved from 167.49 ± 6.25 to 177.08 ± 4.39 (p < 0.001). No difference in AJLO was found between both sides preoperatively (p = 0.329). At the last follow-up, in side A, the AJLO changed significantly into less varus from -7.11 ± 5.44° to -1.10 ± 4.91° (p < 0.001); in side B, the AJLO showed no significant changes (-6.38 ± 6.10° versus -6.65 ± 6.50°, p = 0.970). For side A, the KOOS and AOFAS showed significant improvement, 45.20 ± 14.94 versus 75.72 ± 13.28 (p < 0.001) and 70 (65-75) versus 90 (80-90; p < 0.001), respectively. The preoperative HKA and AJLO on side A and side B showed significant positive correlations (r = 0.591, p < 0.001 and r = 0.611, p < 0.001, respectively). On side A, the postoperative HKA and AJLO showed a significant positive correlation (r = 0.298, p = 0.012). The preoperative and postoperative AJLO and AOFAS on side A showed nonsignificant negative correlations (r = -0.202, p = 0.277 and r = -0.115, p = 0.537, respectively). The preoperative and postoperative HKA and AOFAS on side A showed nonsignificant positive correlations (r = 0.126, p = 0.499 and r = 0.331, p = 0.069, respectively). The linear regression analysis indicated that for every 1° correction in HKA, the AJLO changed by 0.5° (R² = 0.241, 95% confidence interval (CI) 0.298-0.747, p < 0.001).</p><p><strong>Conclusions: </strong>The ipsilateral ankle joint realigned to a less varus position after ipsilateral TKA for managing knee OA with varus deformity, with an estimated half a degree of less varus AJLO after HKA correction by a degree. No changes occurred in the contralateral ankle joint. The ankle joint function improvement was not correlated to the HKA or AJLO changes.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"37 1","pages":"26"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revision of unicondylar knee arthroplasty: an analysis of failure rates and contributing factors.","authors":"Dominik Szymski, Josina Straub, Nike Walter, Yinan Wu, Oliver Melsheimer, Alexander Grimberg, Volker Alt, Arnd Steinbrueck, Markus Rupp","doi":"10.1186/s43019-025-00276-3","DOIUrl":"10.1186/s43019-025-00276-3","url":null,"abstract":"<p><strong>Background: </strong>The implantation rate of knee arthroplasty and, in particular of unicondylar knee arthroplasty (UKA), is increasing, and revision is a feared complication. The aim of this study was to identify factors influencing aseptic and septic revision that are of high interest for establishing preventive measures.</p><p><strong>Methods: </strong>Data were collected using the German Arthroplasty Registry (EPRD). Patients with UKA were analyzed using the multiple Log-rank test with Holm's method. Septic and aseptic revisions were calculated using Kaplan-Meier estimates. In total, 300,998 cases of knee arthroplasty were identified in the registry, and 36,861 patients with UKA were analyzed with a maximum follow-up of 7 years.</p><p><strong>Results: </strong>The primary reason for UKA revision surgery was aseptic loosening (32.5%), particularly loosening of the tibial component (19.0%), followed by infection (11.0%) and the progression of arthritis (10.0%). Over 7 years, 8.7% of UKA procedures required revision, 7.8% for aseptic causes and 0.9% for infection. Risk factors for aseptic revision included uncemented implants [hazard ratio (HR) 1.38] and low annual surgical volume (fewer than 25 UKAs/year, HR 1.86; fewer than 50 UKAs/year, HR 1.43). Significant risks for septic revision were grade III obesity (HR 1.83), male sex (HR 1.69), and high comorbidity scores (Elixhauser > 5, HR 1.67). The surgical volume did not affect septic revision rates.</p><p><strong>Conclusion: </strong>Aseptic loosening is the primary cause of UKA revision, influenced by implant type and low surgical volume, while septic revisions are associated with patient factors such as obesity, male sex, and comorbidities. Improvements in implant selection, surgical expertise, and patient risk management may reduce revision rates.</p><p><strong>Level of evidence: </strong>III, retrospective case-control study.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"37 1","pages":"25"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateralized position of femoral and tibial components during posterior-stabilized total knee arthroplasty leads to better functional outcomes.","authors":"Shinichiro Nakamura, Yoshihisa Tanaka, Shinichi Kuriyama, Kohei Nishitani, Yugo 侑吾 Morita, Yugo 悠吾 Morita, Sayako Sakai, Yuki Shinya, Shuichi Matsuda","doi":"10.1186/s43019-025-00275-4","DOIUrl":"10.1186/s43019-025-00275-4","url":null,"abstract":"<p><strong>Background: </strong>The mediolateral position and postoperative translation of the femoral and tibial components relative to the respective bones after total knee arthroplasty (TKA) have not yet been investigated. The purpose of the current study was to investigate the effect of the mediolateral position of the femoral and tibial components on clinical outcomes including muscle strength and ambulatory function.</p><p><strong>Methods: </strong>A total of 86 consecutive knees were included. The mediolateral positions of the femoral and tibial components were measured on the postoperative long-leg radiographs. The mediolateral position of the femoral and tibial components was defined relative to the femoral distal anatomical axis and the tibial mechanical axis. The lateral position of the component was denoted as positive. The lateral translation of the femoral and tibial components was defined as the distance between the preoperative femoral and tibial centers and the postoperative center of the respective component. The Knee Society Score (KSS), New Knee Society Score (2011 KSS), and the Timed Up and Go (TUG) test results were evaluated 2 years postoperatively. Spearman's correlation coefficient was calculated.</p><p><strong>Results: </strong>The lateral position of the femoral component was significantly positively correlated with KSS function score (ρ = 0.250, p = 0.020), 2011 KSS functional activities (ρ = 0.258, p = 0.017), and TUG values (ρ = - 0.241, p = 0.027). The lateral translation of the tibial component was significantly correlated with knee extension strength (ρ = 0.259, p = 0.017).</p><p><strong>Conclusions: </strong>The lateralized position of the femoral and tibial components positively influenced postoperative knee function. When the width of the component does not fit the resected surface, a lateralized position of the femoral and tibial components with respect to the respective bones can be recommended for better functional outcomes.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"37 1","pages":"24"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive analysis of knee cysts: diagnosis and treatment.","authors":"Mahmod Hasan, Yaron Berkovich, Bilal Sarhan, Yaniv Steinfeld, Eyal Ginesin, Sobhe Hijaze, Ali Sleiman, Yaniv Yonai","doi":"10.1186/s43019-025-00269-2","DOIUrl":"https://doi.org/10.1186/s43019-025-00269-2","url":null,"abstract":"<p><p>Knee cysts are a common finding in orthopedic practice, with diagnoses that range from benign fluid collections to more complex lesions requiring intervention. This comprehensive review explores the types of cysts around the knee, including popliteal (Baker's) cysts, meniscal cysts, proximal tibiofibular joint cysts, and ganglion cysts within the cruciate ligaments. The review highlights the mechanisms of formation, clinical presentations, diagnostic methods, differential diagnoses, and treatments for each cyst type. Imaging, particularly MRI, plays a critical role in accurate diagnosis, helping differentiate cysts from other pathologies, such as tumors and vascular lesions. Treatment options vary, from conservative management for asymptomatic cases to surgical interventions, such as arthroscopic cyst removal, for symptomatic cysts or those associated with intra-articular pathologies. Emerging biological treatments, including platelet-rich plasma (PRP) and mesenchymal stem cell (MSC) therapies, show promise for addressing underlying joint degeneration and inflammation associated with certain cysts, particularly those linked to osteoarthritis. This review underscores the importance of tailored, evidence-based approaches in managing knee cysts to optimize patient outcomes. Keywords: Knee Cysts, Popliteal Cyst, Meniscal Cyst, Proximal Tibiofibular Joint Cyst, Joint Pathology.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"37 1","pages":"23"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double-level knee valgization osteotomy has high survivorship and a low complication rate in a single-center series of 58 cases with a mean clinical follow-up of 10 years.","authors":"Ahmed Mabrouk, Michael Risebury, Sam Yasen","doi":"10.1186/s43019-025-00271-8","DOIUrl":"10.1186/s43019-025-00271-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Double-level knee osteotomy (DLO) is becoming more popular in bifocal (femur and tibia deformities) as it addresses the deformity where it belongs and results in a more physiologic joint line obliquity. This study reports on the early to midterm outcomes, both clinical and radiological, of valgization DLO for varus knees and the first study to report the 10-year survivorship of this procedure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective review of a prospectively maintained single-center database of 1170 knee osteotomies was undertaken. Patients with bifocal (femur and tibia) varus malalignment and isolated medial compartment osteoarthritis who had DLO corrections [high tibial osteotomy (HTO) and distal femoral osteotomy (DFO)] were included. Multiple patient-reported outcome measures (PROMs) were recorded preoperatively and serially postoperatively. This included the Knee Injury and Osteoarthritis Outcome Score, the Oxford Knee Score, the Oxford Knee Score-Activity and Participation Questionnaire, the Western Ontario and McMaster University Score, the visual analog scale for health and pain, and the EQ-5D. EQ-5D stands for EuroQol 5-dimension. It is a standardized instrument for measuring health-related quality of life (HRQoL). All lower limb alignment indices were recorded pre-and postoperatively. The rates of osteotomy revision, conversion to arthroplasty, complications, and both 8- and 10-year survivorship were recorded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 58 valgization DLO cases were followed up to a mean of 10.8 ± 3 years. This comprised 74.1% males and 25.9% females, with a mean age of 47.9 ± 9.8 years and a mean body mass index (BMI) of 31.5 ± 6.3 kg/m&lt;sup&gt;2&lt;/sup&gt;. The mean planned correction angles for HTO and DFO were 7.7° ± 2.7° and 7.7° ± 3°, respectively. Postoperatively, the mean mechanical tibiofemoral angle improved from -12.7° ± 3.9° (varus) to -0.4° ± 3.4° (i.e., centered around mechanical neutral), the mean medial proximal tibial angle improved from preoperative 84.3 ± 3.2° to postoperative 90° ± 2.5°, the mean mechanical lateral distal femoral angle improved from preoperative 91.6° ± 3.4° to postoperative 86.7° ± 2.5°, and the mean Mikulicz point improved from -5 ± 13.4% to 47.7 ± 14.7% (all p-values &lt; 0.001). All PROMs significantly improved at 24 months follow-up (all p values &lt; 0.001). The rate of osteotomy revision was 3.4%. The overall rate of total knee arthroplasty conversion was 5.2% at an average of 5.9 ± 3.1 years postoperatively. The complication rate was 8.6%. The 8- and 10-year survivorship was 97.1%, and 94.4%, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this single-center series evaluating patients with varus knees and bifocal deformities, valgization double-level knee osteotomy (DLO) demonstrated favorable clinical outcomes, accompanied by a low complication rate of 8.6% and a 10-year survivorship of 94.4%. Radiographic findings from available imaging data wer","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"37 1","pages":"22"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the anterolateral ligament of the knee: a bibliometric analysis.","authors":"Hale Öktem, Yusuf Jamil, Sinem Nur Sever","doi":"10.1186/s43019-025-00274-5","DOIUrl":"https://doi.org/10.1186/s43019-025-00274-5","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate research trends, key contributors, and thematic focuses in research of the anterolateral ligament (ALL) of the knee. It seeks to identify future direction for studies related to long-term clinical outcomes regarding ALL's role in rotational stability, especially in the context of anterior cruciate ligament (ACL) injuries.</p><p><strong>Methods: </strong>A bibliometric analysis was conducted using the Web of Science (WoS) database, covering publications from 2012 to 2024 with the search term \"anterolateral ligament\". A total of 942 studies were identified. Descriptive statistics summarized publication trends, authorship, institutional contributions, and citation metrics. VOSviewer software was used to analyze co-authorship network analysis, keyword co-occurrence mapping, and total citation analysis. Yearly publication and citation trends were analyzed using WoS data. Studies addressing the ALL in other body regions were excluded. Additionally, only authors with at least one publication and one citation were considered, and documents with more than 25 authors were excluded. A total citation analysis was conducted, and 24 relevant keywords with more than 5 occurrences were identified using VOSviewer.</p><p><strong>Results: </strong>Among 942 publications, 707 were original articles. Research output peaked in 2017 (125 articles). Sonnery-Cottet was the leading author (75 publications), while Universidade De São-Paulo emerged as the top institution (57 publications). Key journals included Arthroscopy: Journal of Arthroscopic and Related Surgery (143 articles) and The American Journal of Sports Medicine (131 articles). Keywords such as \"anterior cruciate ligament\", \"reconstruction\", and \"rotational stability\" dominated, reflecting a focus on ACL injury management. The top ten cited studies accrued 3,86 citations, with Claes et al.'s anatomical study leading (621 citations). Of the 942 ALL-related articles in WoS, 381 focused on anatomy (11,278 citations) while 814 addressed reconstruction (17,048 citations). Keyword trends shifted from anatomical to clinical terms, with anatomy declining and stability, injury, and outcomes gaining prominence from 2021 to 2024.</p><p><strong>Conclusions: </strong>This bibliometric analysis underscores the growing interest in ALL research, peaking between 2016 and 2017. While foundational studies on ALL anatomy and biomechanics appear saturated, future research should prioritize clinical outcomes in terms of failure rate, reoperation, the long-term efficacy of ACL-ALL reconstruction, and advancements in imaging techniques.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"37 1","pages":"21"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thromboembolic and infectious complication risks in TKA and UKA: evidence from a Japanese nationwide cohort.","authors":"Yu Mori, Kunio Tarasawa, Hidetatsu Tanaka, Masayuki Kamimura, Kento Harada, Naoko Mori, Kiyohide Fushimi, Toshimi Aizawa, Kenji Fujimori","doi":"10.1186/s43019-025-00273-6","DOIUrl":"https://doi.org/10.1186/s43019-025-00273-6","url":null,"abstract":"<p><strong>Introduction: </strong>Total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) are widely used to treat knee osteoarthritis. TKA significantly contributes to long-term pain relief and joint function improvement, while UKA offers faster recovery and reduced early complications. However, TKA and UKA complication risks, aside from conditions such as deep vein thrombosis, have not been thoroughly investigated. This study compares the in-hospital complication risks of TKA and UKA using a nationwide Japanese database.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using data from the Japanese Diagnosis Procedure Combination (DPC) database, spanning from April 2016 to March 2023. A total of 259,319 knee arthroplasty cases (TKA: 228,595; UKA: 30,724) were analyzed. Propensity score matching (1:1) was used to adjust for age, sex, comorbidities, and surgical factors, resulting in 30,591 matched pairs. Multivariable logistic regression analyses assessed the risks of complications, including deep vein thrombosis, pulmonary embolism, and surgical site infections.</p><p><strong>Results: </strong>Deep vein thrombosis is frequently observed as a complication with a high incidence rate. Even after propensity score matching, the incidence remained significantly higher in the TKA group (8.8%) compared with the UKA group (6.1%) (p < 0.0001). TKA was associated with significantly higher risks of deep vein thrombosis (odds ratio (OR): 1.467, 95% confidence interval (CI) 1.380-1.560, p < 0.0001), pulmonary embolism (OR: 1.709, 95% CI 1.182-2.470, p = 0.0044), and surgical site infection (OR: 1.512, 95% CI 1.277-1.790, p < 0.0001) compared with UKA. UKA showed lower risks of cognitive dysfunction, pneumonia, transfusion requirements, and shorter hospital stays. However, patients who underwent UKA had a higher risk of periprosthetic fractures.</p><p><strong>Conclusions: </strong>This study highlights the distinct risk profiles of TKA and UKA, emphasizing the need for tailored surgical decision-making. UKA offers advantages in reducing complications for specific patient populations. Strengthening prophylactic measures is crucial for effectively managing thromboembolic and infectious complications in patients undergoing TKA.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"37 1","pages":"19"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the coronal plane alignment of the ankle and subtalar joints normalize after total knee arthroplasty?","authors":"Katsuki Yamaguchi, Tatsuya Sakai, Masanori Fujii, Satoshi Takashima, Shuichi Eto, Yosuke Matsumura, Satomi Nagamine, Hirofumi Tanaka","doi":"10.1186/s43019-025-00272-7","DOIUrl":"https://doi.org/10.1186/s43019-025-00272-7","url":null,"abstract":"<p><strong>Background: </strong>Total knee arthroplasty (TKA) alters the lower extremity alignment, potentially affecting adjacent joints such as the ankle and subtalar joints. However, the relationship between changes in hindfoot alignment and ankle osteoarthritis (OA) after TKA remains incompletely understood. The purpose of this study was to clarify whether ankle and subtalar alignment normalizes after TKA and to identify factors associated with persistent malalignment.</p><p><strong>Methods: </strong>We retrospectively analyzed 331 patients who underwent unilateral mechanical alignment (MA) TKA for knee osteoarthritis. A control group of 40 healthy subjects was used to define normal alignment ranges. Whole-leg anteroposterior weight-bearing radiographs were obtained preoperatively and 2 months postoperatively. Alignment parameters included the hip-knee-ankle angle (HKA), tibiotalar tilt angle (TTA), tibial plafond inclination angle (TPIA), talar inclination angle (TIA), and hindfoot alignment angle (HAA). Pre- and postoperative values were compared using the Wilcoxon signed-rank test, and changes in the proportion of patients within the normal range were determined. Wilcoxon rank-sum tests and chi-squared tests were used for group comparisons, and multivariate logistic regression identified independent predictors of persistent malalignment.</p><p><strong>Results: </strong>HKA improved after TKA (-12° to -2.0°), with corresponding improvements in TPIA (99° to 94°) and TIA (99° to 95°) (all p < 0.001), indicating a significant correction toward neutral alignment. The proportion of patients within normal range increased postoperatively from 16% to 85% for HKA, 26% to 67% for TPIA, 24% to 64% for TIA, and 65% to 73% for HAA. Multivariate analysis identified ankle OA (odds ratio [OR] = 6.62 for TTA), female sex (OR = 2.32 for TPIA; OR = 3.19 for TIA), and varus knee alignment (OR = 2.81 for TIA) as independent predictors of persistent malalignment.</p><p><strong>Conclusions: </strong>MA-TKA facilitates partial normalization of coronal hindfoot alignment, particularly at the tibial plafond and talus. However, female sex, varus knee deformity, and pre-existing ankle OA independently limit full correction. These findings highlight the biomechanical interdependence between the knee and hindfoot and may guide surgical decision-making and patient-specific alignment strategies.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"37 1","pages":"20"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do surgically treated multiligamentous knee injuries affect overall complication rate and especially stiffness? A systematic review.","authors":"Lucas Martorell de Fortuny, Alexandre Santoli, Vasileios Giovanoulis, Angelo V Vasiliadis, Simone Perelli, Joan Carles Monllau, Az-Eddine Djebara, Nicolas Pujol","doi":"10.1186/s43019-025-00270-9","DOIUrl":"https://doi.org/10.1186/s43019-025-00270-9","url":null,"abstract":"<p><strong>Background: </strong>Multiligamentous knee injuries (MLKIs), defined as injuries involving at least two of the four primary knee ligaments, are rare but severe, with potentially limb- or life-threatening complications. Despite numerous publications, the low incidence and heterogeneity of injury patterns limit high-level evidence for optimal surgical timing, technique, and management of complications. This systematic review aims to consolidate the available evidence on MLKI surgery complications, with a particular focus on arthrofibrosis as the underlying cause of stiffness, infection, and graft failure.</p><p><strong>Methods: </strong>This systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 guidelines and registered in the International Prospective Register of Systematic Reviews (PROSPERO) (no. CRD42024618025). A comprehensive search of PubMed, EMBASE, and MEDLINE from January 2013 to November 2024 identified studies reporting complications in surgically treated MLKIs with at least a 12-month follow-up. The studies were screened independently by two reviewers. Data on demographics, injury mechanisms, surgical techniques, and complication outcomes were extracted. Study quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS).</p><p><strong>Results: </strong>A total of 33 studies with 2863 patients met the inclusion criteria. The mean age was 32.4 years (standard deviation, SD ± 5.37), with males constituting 69.4% of the sample. Arthrofibrosis was the most common complication, requiring surgical management in 8.4% of cases. Graft failure was reported in 5%, while infection, the third most common complication, occurred in 2.86% of cases. Management of lack of range of motion varied, with manipulation under anesthesia and arthroscopic arthrolysis utilized. Surgical timing also influenced outcomes; 54.2% of patients underwent acute surgery (< 21 days), which seems to be associated with increased stiffness rates.</p><p><strong>Conclusions: </strong>This systematic review highlights the complexity of managing MLKIs, with a 19.2% overall complication rate. Stiffness demanding reoperation remains a rare but a significant challenge, underscoring the need for standardized treatment protocols. However, the included studies demonstrate heterogeneity and lack high methodological rigor, highlighting the need to account for these limitations.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"37 1","pages":"18"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Accurate, automated classification of radiographic knee osteoarthritis severity using a novel method of deep learning: Plug‑in modules.","authors":"Do Weon Lee, Dae Seok Song, Hyuk-Soo Han, Du Hyun Ro","doi":"10.1186/s43019-025-00268-3","DOIUrl":"https://doi.org/10.1186/s43019-025-00268-3","url":null,"abstract":"","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"37 1","pages":"17"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}